(Affidavit of Intent and Consent to Adoption of Child)

Republic of the Philippines)

Metro Manila ) S.S.
Quezon City )

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AFFIDAVIT OF INTENT AND CONSENT

I, _________________, a Filipino citizen, of legal age, single and presently

residing at _____________________, having been duly sworn in accordance with
law, hereby depose and state:

1. That I am the legitimate daughter of ____________ and _____________,

born on _______________ in Quezon City, Philippines.
2. That I consent to the adoption of the child, _____________________. 
3. That I was the one who gave the child the name ___________________.
4. That I shall support and take care of the said child as if she were my own
sister by blood.
5. That I also signify my written consent, freely, willingly and
voluntarily to have this child, __________________________, be legally
adopted by my biological and legitimate parents __________________ and
_______________________ of Quezon City, Philippines in accordance with
law.
6. That I execute this affidavit to declare my intention and consent to the
adoption of ______________________ as well as to the truth of the
foregoing facts.

Signed in the Presence of:

1
 (Affidavit of Intent and Consent to Adoption of Child)

___________________________ ____________________________

IN WITNESS WHEREOF, hereunto set my hands this ______ day of

____________ 2017, Quezon City, Metro Manila.

_________________________
Affiant